Abortions

Last week appeared the first complete, authoritative medical textbook on how to produce and prevent abortions.* Forty-six centuries ago a Chinese emperor wrote down the first medical prescription for bringing about abortions. A thousand years later an Egyptian described on papyrus the tools necessary for the surgical production of abortion.

Jews and Christians are on theological principle opposed to any procedure which interrupts pregnancy. Nevertheless Dr. Frederick Joseph Taussig, famed St. Louis gynecologist, author of last week's milestone text, finds that every tribe, nation, people and race from time immemorial has practiced abortion. After careful figuring, he decided that 681,600 abortions occur each year in the U. S., causing some 10,000 maternal deaths. According to Dr. Taussig, much of this mortality is due to secretiveness growing out of laws which declare abortions criminal unless performed to preserve the health or life of the mother.

Borderline between an abortion and a premature birth is vague. In the regular course of nature a baby is born 269 days after conception. Rare indeed is the baby born before the 26th week who survives./- Those delivered dead before that period are known professionally as abortions. Those delivered, dead or alive, after that period are called premature births.

A fall, a blow, a scare, a rage, a chill, writes Dr. Taussig, may cause spontaneous abortion. Spontaneous abortions may also result from defective ova, weakness of the placenta, nervous wombs, malformed pelvis, dietary deficiencies, endocrine disturbances. Half the women who suffer from typhoid fever, cholera, scarlet fever, smallpox, erysipelas, sleeping sickness and malaria during pregnancy involuntarily abort. Pneumonia is especially feticidal.

Lead is the most common chemical poison causing abortion. Dr. Taussig found that chronic alcoholism may cause abortions, but "it is improbable that cigaret smoking even to excess can lead to" that termination of pregnancy. More boys are born alive than girls. More male fetuses are aborted than female fetuses. Some investigators believe that this preponderance of male conceptions over female conceptions is nature's way of compensating for the fact that unborn males are less sturdy than unborn females. Dr. Taussig scoffs at this theory of "genetic weakness" in males. Concerning male abortions he reasons that male fetuses make heavier demands on the mother's body, which she cannot always endure. Another Taussig explanation: female hormones in the mother's blood poison her unborn son.

Laws against performing abortions vary from Mississippi, "where an abortion is permitted by any person who acts on advice of a physician," to New Hampshire, "where any person who wilfully administers a drug or uses an instrument to procure an abortion is punished by fine or imprisonment."

Nonetheless a U. S. doctor is seldom prosecuted for performing a "criminal operation." He can generally claim that he did it to preserve the life or health of the woman, a legal obligation of his profession. After a search of Federal and state laws, Dr. Taussig assured doctors that their colleagues have performed therapeutic abortions without professional risk for any one of the following legitimate reasons: "1) very recent pregnancy; 2) general debility with loss of weight; 3) after suppurative appendicitis that has produced extensive adhesions; 4) after a previous Caesarean operation; 5) to prevent increasing prolapse of the pelvic organs; 6) after plastic repair of the pelvic eugenic floor to reasons such prevent as a birth of recurrence; 7) eugenic reasons such as birth of a defective child or parental feeblemindedness; 8) suicidal tendencies; 9) economic reasons in women of high fertility; 10) previous postpartum infection; 11) co existing malignant disease; 12) necessity of travel to remote regions where pregnancy cannot be properly cared for." In addition: "While our own laws and those of other countries do not as a rule recognize rape or extreme youth as indications for abortion, we as physicians, knowing the harmful mental or physical effects produced by a pregnancy in such cases, should seek to justify an abortion for medical reasons. If the abortion is done openly, there is little doubt that the courts would uphold such a decision."

Dr. Taussig gives the following advice to doctors who find themselves called upon to perform therapeutic abortions: "Since the physician must in every case of abortion strive to keep his name clear of any suspicion of malpractice, it is naturally preferable for him to treat every patient with this condition in a hospital, where records are kept and the presence of nurse or interne prevents any possible efforts at blackmailing by unscrupulous persons. It is relatively easy for a man in city practice to carry this out, but in a very considerable number of cases handled in country or small town practice this will not be feasible. Here the necessary procedures will often have to be carried out either in the doctor's office or at the home of the patient. Even under these conditions it would be best if the physician have some third person such as a nurse or assistant present at the time of the treatment."

A great German family name in St. Louis is Taussig. Some are Gentiles, some Jews, some a mixture of both. Most eminent of the last are the doctor Brothers Taussig: Internist Albert Ernst, 64, a Unitarian; Gynecologist Frederick Joseph, 63, an Ethical Culturist. Like most male St. Louis Taussigs, both brothers went to Harvard for undergraduate education. They, and later Albert's two sons, returned to Washington University for medical training. Orphans of a wealthy Jewish banker-broker, reared by two spinster aunts, they lived well at school, got a running start in the practice of medicine.

A handsome man, grey and bespectacled of average height and solidly built, Dr. Fred dresses with extreme care, in contrast to tall, cadaverous Dr. Albert. The late, great Jane Addams always was houseguest of the Fred Taussigs when she went to St. Louis. Because he is so strict and meticulous in his clinical work, students and younger gynecologists who work with Dr. Fred in clinics consider him old-maidish. Internist Albert is considered to have a larger practice than Gynecologist Fred.

*Abortions, Spontaneous & Induced--Frederick J. Taussig. M. D.--Mosby ($7.50).

/-Living in Chicago last week was Jacqueline Jean Benson, a six-month baby who weighed 12 oz. when born last January.

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